Courtesy of Felix 42

Courtesy of Felix 42

The New England Journal of Medicine. 2014. 370(15):1402-141

Among patients with severe sepsis or septic shock, does administration of albumin 20% solution to maintain serum albumin level ≥3 g/dL reduce all-cause mortality at 28 days when compared to no albumin?

Multi centre, open label. randomised trial.

Inclusion criteria

Suspected or proven infection in one site or more. Meets criteria for SIRS.

One or more severe organ dysfunction.

Method

Patients were stratified by time meeting severe sepsis criteria to one of two groups:

Albumin – Following randomization, administration of 300 mL albumin 20% solution then albumin 20% solution IV daily to maintain serum albumin concentration ≥3 g/dL for days 1-28 or until discharge from ICU (whichever came first)

No albumin – No albumin administered

Early fluids were administered according to EGDT protocol.

Outcome

Among patients with severe sepsis or septic shock, daily administration of albumin to maintain serum albumin ≥3 g/dL was not associated with a reduction in all-cause mortality at 28 days when compared to no albumin.

In this icTV interview video, Luciano Gattinoni discusses his recent trial: Albumin for Volume Replacement in Severe Sepsis (ALBIOS). He describes the objectives and reports early results from this sepsis trial and suggests that while they are still awaiting conclusive results, perhaps findings may show that there are specific patient groups in which treatment with Albumin may prove to be beneficial. Link here…

PulmCCM viewpoint

Thinkingcriticalcare has the view that this study confirms their belief that giving albumin is safe practice….

….despite the meta analysis from the Cochrane group suggesting that it was not a good fluid to give.

Originally posted 2013-02-19 04:16:57. Republished by Blog Post Promoter

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One Response to The ALBIOS Trial: Albumin in Severe Sepsis?

  1. Hi Jonathan, I have to confess my current views on albumin are ambivalent, given recent discussions with Tom Woodcock and the concern with the glycocalyx… I am hoping for more research on this to be available, so although I still use it, I do so less than before.

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